Surveillance of neonatal endotracheal tube colonisation
Research type
Research Study
Full title
Surveillance Study of Endotracheal Tube Microbial Colonisation in Neonatal Intensive Care Units
IRAS ID
357143
Contact name
Don Sharkey
Contact email
Sponsor organisation
University of Nottingham
Duration of Study in the UK
1 years, 6 months, 31 days
Research summary
Babies born prematurely are more susceptible to late onset infections (LOIs) due to their immature immune systems, which occur after 72 hours of age. These are associated with death and long-term disease such as bronchopulmonary dysplasia (a life-long severe breathing condition), neurodevelopmental impairment and cerebral palsy.
Newborn babies admitted to neonatal intensive care units have never gone home and so in most cases acquire these LOIs in hospital. Many premature or sick babies require life support from medical devices such as breathing and feeding tubes, intravenous lines and incubators. Whilst lifesaving, up to 76% of these devices become colonised with harmful bacteria within 24 hours of use. These bacteria can stick together and form a slimy coating called biofilm on surfaces, which acts like a shield, making them up to 1000 times more resistant to antibiotics and body’s immune system clearance. Thus, making eradication a real challenge. As an example, the endotracheal tube (ETT), a breathing tube is used to ventilate premature babies, which can quickly become colonised by bacteria, increasing the risk of ventilator-associated pneumonia. These tubes are made of plastic chemicals, commonly used to make them softer and more flexible, which have been shown to leach with time.
At present, there is a paucity of data of bacterial biofilm colonisation of breathing tubes in the UK neonatal population. We proposed conducting the first surveillance study on biofilm and bacterial colonisation in neonatal ETTs in the UK. This will help us understand better how biofilm forms in ETTs of ventilated babies and map common harmful bacteria within a UK neonatal cohort. These invaluable data including data on plastic chemicals from breathing secretions will inform the planning of a future clinical trial of coated ETTs which will resist biofilm formation.
REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
26/WM/0115
Date of REC Opinion
4 Jun 2026
REC opinion
Further Information Favourable Opinion